Objective: To investigate the effect of acupuncture on default mode network (DMN) in migraine patients without aura based on functional Magnetic Resonance Imaging (fMRI).
Methods: Fifteen patients with migraine were included and treated with acupuncture based on "root-knot" theory (Zuqiaoyin [GB 44] for shaoyang headache, Lidui [ST 45] for yangming headache, Zhiyin [BL 67] for taiyang headache, and ashi point), once every other day, three times a week for 4 weeks. The patients received fMRI scanning before and after acupuncture treatment, the effect of acupuncture on DMN in patients with migraine was observed; the frequency of migraine attack, visual analogue scale (VAS) score and the using of analgesic medication before and after treatment were recorded to evaluate the curative effect of acupuncture; the migraine-specific quality of life questionnaire (MSQ), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the improvements of quality of life and emotional state.
Results: Compared before acupuncture, the functional connections of left parahippocampal cortex (PHC) and anterior medial prefrontal cortex (aMPFC), dorsal medial prefrontal cortex (dMPFC) and lateral temporal cortex (LTC) in DMN after acupuncture were weakened (P<0.05), and the functional connections of bilateral posterior cingulate cortex (PCC) and dMPFC were weakened (P<0.05). Compared before treatment, the frequency of migraine attack, VAS, SAS and SDS scores after treatment were decreased (P<0.05), and MSQ score was increased (P<0.05).
Conclusion: Acupuncture shows good clinical efficacy for migraine without aura, and could adjust the functional connection of DMN.
目的：基于功能磁共振成像（fMRI）技术探讨针刺对无先兆偏头痛患者默认模式网络（DMN）的影响。方法：纳入15例偏头痛患者，采取基于“根结”理论辨经选穴的针刺治疗（如少阳头痛取足窍阴、阳明头痛取厉兑、太阳头痛取至阴，及阿是穴），隔日1次，每周3次，共治疗4周。患者于针刺治疗前后各接受1次颅脑fMRI扫描，观察针刺对偏头痛患者DMN的影响；记录治疗前后偏头痛发作频率、视觉模拟量表（VAS）评分、止痛药服用次数评估针刺疗效；采用偏头痛特异性生活质量问卷（MSQ）、自评焦虑量表（SAS）、自评抑郁量表（SDS）评估针刺对生活质量和情绪状态的改善。结果：针刺治疗后偏头痛患者DMN内的左侧海马旁回（PHC）与前内侧前额叶皮层（aMPFC）、背内侧前额叶皮层（dMPFC）、颞旁叶（LTC）功能连接较治疗前减弱（P<0.05），双侧后扣带回（PCC）与dMPFC功能连接较治疗前减弱（P<0.05）。与治疗前比较，针刺治疗后偏头痛发作频率、VAS评分、SAS及SDS评分均降低（P<0.05），MSQ评分升高（P<0.05）。结论：针刺治疗无先兆偏头痛患者具有良好的临床疗效，并可调节DMN的功能连接。.
Keywords: "root-knot" theory; acupuncture; default mode network (DMN); migraine; resting-state functional Magnetic Resonance Imaging (rs-fMRI).